1. Field of the Invention
The present invention pertains to a shoe or sandal specifically designed to aid in the offloading, or reducing weight or pressure, from a specific area of the foot. The shoe or sandal, and specifically the insole and outer covering of the shoe upper, are designed to be altered by or under the direction of the health care provider to either offload weight from the bottom of the foot or to remove or reduce pressure from the sides, top or other specific areas of the foot.
The incidence of foot ulcers, infections and deformities of the feet has become an increasing problem as the life expectancy of patients with diabetes and other chronic diseases increase. The cost of treatment of these complex foot problems has escalated to the point that the Center for Disease Control and others in the health delivery system are placing a special emphasis on finding more effective ways of treating these problems. Patients with circulatory problems, diabetes, AIDS, arthritis neuropathies and other debilitating diseases experience complications that lead to increased deformities in the feet subjecting the deformed areas to increased pressures and friction. Spinal cord injuries and other injuries to the back and lower extremities may cause neuropathies that in turn produce deformities in the toes and feet with a loss of feeling causing more complications to develop. Chemically induced neuropathy from chemotherapy, alcohol, drug abuse, etc., may also lead to ulcerations and lesions of the feet that require special care. All of these problems are exacerbated by weight bearing pressure or friction from conventional shoes. Regardless of how aggressive the treatment plan, the use of expensive antibiotics, local wound care, surgery etc., healing is delayed and the lesions and infections reoccur unless effective measures are taken to redistribute weight reducing pressure and friction from the involved foot lesions.
2. Description of the Related Art
Orthotics (othopedic inserts) for supporting certain aspects of the human foot are well known in the field of podiatric medicine. However, orthotics can produce added pressure on the supported areas and cause rubbing which may lead to blistering or other ailments, complicating the above-described problems. Orthotics require additional space when used in conjunction with standard insoles and may even require extra space when comprised in a customized insole. Thus, when used in normal mass market shoes, orthotics can also cause rubbing on opposite surfaces of the foot, due to reduced clearance between foot and the shoe upper. Othopedic shoes such as those manufactured by Markell® and others provide extra depth to accommodate foot deformities and/or orthotics, but have an extremely awkward appearance, generally having a much higher profile (taller appearance) than normal mass-market shoes, and can be unstable when multiple inserts are used.
The wound care shoe system is designed to produce a foot friendly environment where pressure and friction are reduced allowing healing to take place and to reduce the incidence of reoccurrence of a lesion. The invention provides an easy to use healing shoe or sandal and an effective method to offload weight from a particular area of the plantar aspect (bottom) of the human foot by using alterable insoles or insole layers of varying densities and degrees of firmness which fit into an area surrounded by a circumferential counter, in order to hold the insole layers in position. This creates a low profile more stable shoe than prior art extra depth shoes. The outer covering of the upper is also constructed of materials that can be cut out or heat molded or otherwise altered to reduce friction and/or pressure from the non-weight bearing areas of the foot.